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Archive for the ‘Ye Olde Fertility Clinic’ Category

Plan

I had my consult with SuperDoc today; I will write about it more later, but just wanted to say that it happened, I survived, neither of us is super-optimistic, but we have a plan. Plans are good.

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After being up far too late last night, I dragged myself out of bed this morning to go to Ye Olde Fertility Clinic. It wasn’t easy, let me tell you. But I checked my email first and discovered that SquarePeg got two lines yesterday! So that was the first sign that maybe today isn’t going to completely suck!

And then I managed to get out of the house on time (with a shower, even!), which was the second sign of the apocolypse that maybe today wouldn’t completely suck.

Despite the fact that it was raining, I managed to make it to YOFC without too much trouble and I arrived at my appointment on time. (Third sign of the apocolypse, perhaps? Nah. I’m usually very punctual.)

I had a very short wait before I was called back by Dracula (definite sign of the apocolypse AND that today would not totally suck – I should have *known* that today was not going to totally suck). They drew my blood without too much trouble. Apparently I hadn’t had enough to drink, so it wasn’t easy but they managed.

When she was finished, she said, “I’m afraid you’re in room 1 again today.”
“Fine. No mobile in there, still, right?” I sighed dramatically.
“No, I’m sorry.”
“You know, Dr. S. and I are going to have a TALK, he and I.”
“I know…”
“Don’t think I won’t!”
“I’m sorry! They said they ordered one…”
“What. Ever!”
I stalked off to room one (jokingly, of course – it’s not HER fault!) and walked into Room 1.

And.

I looked up.


And I let out an ENORMOUS SHRIEK of Delight!

“SURPRISE!” she shouted!

Ohmygosh, HOORAY!

For three, count ’em, THREE years I have been petitioning for that mobile. I put myself out there in the public eye for that mobile! I waited for two and a half months after those embarrassing television interviews for that mobile to appear! I have endured random people who I never expected to have seen the evening news (I mean, really? WHO WATCHES THE EVENING NEWS ANYMORE??) come up to me in all sorts of places and say, “Hey, I saw you on TV talking about that fertility thing!” to get that mobile!

And it was worth the wait, ladies. WORTH THE WAIT.

The picture was taken with my cell phone, so it doesn’t do that beautiful mobile any justice at all, but it is gorgeous, really gorgeous.

I snapped a photo of it, disrobed, hopped up on the table, and while I was waiting, I emailed it to my husband with a simple note: “Hooray!” The message was still sending when M (sonographer extraordinaire) and Dr. S. walked in the room. I was still elated and overflowing with joy at the sight of that beautiful mobile. Dr. S. truly outdid himself. He told me he didn’t care if it took two hours that morning, I wasn’t getting any other room today, I was getting room one! Oh yeah, baby. Oh yeah.

As for today’s monitoring results? I dunno. Dr. S. says I’m on the every day plan, now. My lining was 10.1. On the left, I’ve got a 16.3 and a 15.2. On the right, I’ve got a 17.7, 12.6 and a 10.4. My fears of a lead follicle are evaporating, thankfully, but there’s nothing else to be seen. And I feel like – the whole point of shifting around protocol this time was to avoid another scenario where we were looking at 4-5 follicles at this stage of the game. I know I’m being greedy. And I know last time we were looking at four and ended up with 10, so all is not lost yet. But this is my 2nd of 3 tries at this clinic and then I’m done. I’m feeling anxious about it, even if I know it’s unfounded. Better not to worry until I hear what my E2 and LH are, which I should know later in the day. I’ll keep you updated.

Meanwhile, I feel like I have finally accomplished something. Now, all women who come after me to Ye Olde Fertility Clinic and are in the Stirrups in Room 1 will have something pretty to look at. And maybe, just maybe, that will ease their anxiety just a little. I feel like I did something for many, many infertiles to come. 🙂

At least, I hope I did.

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So you all know I’ve been doing these interviews for Ye Olde Fertility Clinic. It’s awfully nervewracking, because it’s SO not me. I put on this big act of being all open and extroverted about this stuff, but truthfully? I never talk about this stuff, ever. Well, that’s not true. I do talk about it – but I don’t talk about it publicly while I’m in the middle of a cycle. I go through a treatment cycle under a shroud of secrecy whenever possible.

And yet, three times now, I have sat in front of a television camera with a reporter in front of me and declared to the greater metropolitan area that I am pursuing fertility treatment right now. And why? Well, because Ye Olde Fertility Clinic asked me to, that’s why. And because putting a face and a voice to infertility is important. It’s all together too easy for society to pretend like infertility is “someone else’s problem” and that it’s one of those things we don’t need to talk about. Or worse, one of those things we should be ashamed to talk about.

In some ways, I’m not the poster child for fertility treatment. I was the aberration – the nightmare outcome – the now-mother to HOMs. But I’m also the survival story, and the mother who came back for more, despite knowing the pain, suffering, and inconvenience of it all. And the mother seeking to do this in a the way most likely to result in the best outcome – a healthy singleton pregnancy – by doing elective Single Embryo Transfers.

Infertility and its treatment is a multi-billion dollar industry, that’s for sure – but when it comes down to it, the industry is in the business of making life. Babies. Building families. Sure, there’s a payout in the end, but they earn it. I’ve been to the other side of infertility and I know it’s worth every bit of the toll the process takes and every penny I (and my insurance company) spent. And I also know that there is no way that I can ever repay the kindness that Ye Olde Fertility Clinic has offered me in helping me to build my family. So when YOFC asked me to do these interviews, of course my answer was yes. (With the condition that the mobile gets hung in Room 1 ASAP – oh you thought I’d forgotten about that, didn’t you? No sirree! I have the memory of… um, whatever it is that has a really good memory – I forget)

I know that I’m a giant pain in the ass. I know that I give my doctors a lot of crap. Do you think I don’t know that they probably could live without hearing about the damn missing mobile in Room 1? Do you think I don’t know that they have far more important things on their plates than dealing with me? Of course I know that. But hey, at least I bring them cookies! (Did I mention I brought cookies today?) The fact that they put up with me despite my… ah… we’ll call them idiosyncracies (what can I say? It’s all part of my charm!)… is what makes me love them so much. There is a reason that I refer people to them time and again (aside from their stellar statistics, their cutting edge medicine, and their convenient locations – that’s all secondary to the fact that they are, simply, good people).

But absolutely none of that is why I’m telling you that I have complete faith that my clinic is way cooler than yours. Do you know why I’m telling you that my clinic is so cool? I’ll tell you why!
Because today I went and interviewed with News Station #3, which meant I had the pleasure of meeting once again with J, Marketing Supervisor Extraordinaire*, which is always great. As I said, I brought cookies. Anywhozit, I got to meet with him and meet a lot more of the behind-the-scenes crew at Ye Olde Fertility Clinic, which is always all kinds of fun. I got to see my nurse (and she got a little more camera time, also, which is always fun for her!). The story isn’t airing until March, but I’ll let you peeps know when it airs. I know, I know, my adoring fans *need* to know, right? Of course right.

Afterward, I came home, a little sad knowing that this was my last interview – not because I’m so keen on putting myself all out there and all (honestly, it really IS tiresome to talk quite so publicly about this rather private subject all the time), but because I realized that I pretty much have no excuse to see J (Marketing Supervisor Extraordinaire) anymore or send him random eccentric emails (well, that’s not quite true… that mobile hasn’t been hung yet. He can’t get rid of me until it’s hung!! bwah hah hah!)

And what should appear at my front door a few hours later?

A beautiful Edible Arrangement from J and the Marketing Team at YOFC:

Now, be honest, have any of you ever received such a cool present from your clinic? I can’t hear you! That’s right. I didn’t think so. So just think about that the next time you’re thinking about where to go for treatment, why don’t you. 🙂

*Note the name change – I previously referred to him as “marketing guy” but (God help me) for some reason I was crazy enough to let him know my blog URL and apparently he actually read it (ohmygosh) and felt a little slighted. Seriously, I mean, if my nurse gets to be “NurseAwesome” and my doctor gets to be SuperDoc and my sonographer gets to be M, Sonographer Extraordinaire… but he’s “marketing guy”… well, he had a point when he pointed out that it sounded kinda cold and creepy. Which he is not. He’s one of the nicest people I’ve ever met. He suggested TalentAgent, but unless he’s going to get me a suh-weet deal with one of the stations where I get to market myself as a “childcare expert” on account of my large(ish) family, I’m not *quite* convinced that he can market himself as a Talent Agent just yet. Though, he did manage to get me my first three television appearances. Oh wait, that’s not true, in high school, I appeared on tv bunches of times… Hrm. I think I need an agent…

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As veterans of infertility treatment, we do so many injections that it becomes second nature. We can practically do them without thinking about them. We joke that we could probably do them blindfolded. Well, last night, I almost got my chance. I was in the middle of giving myself one of my two injections and… someone snuck up behind me and blindfolded me! No, wait, that’s not right. Um… Oh right. I was in the middle of giving myself on of my two injections and… the power went out. And flickered back on. And off. And on. And off. And on… and off. And there it stayed. So I’m standing there with a needle hanging out of me wondering what to do, but what are you gonna do, right? So out it came, I found the cap, disposed of the needle appropriately, put everything away in the fridge and said, “Now what?”

Yeah.

So that brings me to last night’s injections. Yes, this post is all backward. The fact that I even had injections to TAKE last night is news, isn’t it? So I started stims last night. Because I had my Lupron evaluation yesterday morning. I got to Ye Olde Fertility Clinic in the morning and Dracula called me back for bloodwork. He only had to bite me twice to get any blood, poor thing. I think he was mortified that he missed, but that’s not shocking. Eventually I got called in to an ultrasound room. No sooner am I in the room and close the door, but I start to unbutton my skirt and in walk M (sonographer extraordinaire) and SuperDoc.

Oh for crying out loud, M, give a girl a minute! M kicked SuperDoc out and turned her back while I bitched at her for rushing me (jokingly of course). “Well, welcome back, huh?” she said, bemusedly. “Yeah, thanks for the warm welcome! I guess you’re the welcoming committee!” Anyway, apparently, my ovaries were sufficiently unperky (7 follicles on the right, 8 on the left… far less than usual), and my lining looked good, and my bloodwork must have looked just fine because I started stims last night – 125 IUs of Follistim and 37.5 IUs of Luveris.

There was a little bit of drama about the Luveris – The Luveris comes in 75 IU unit doses. I’m only taking 37.5 IUs, which is to say … half a vial each night. So I casually said to my husband the other night, “I wonder if I’m supposed to waste half each night, or if I’m supposed to save the other half and take it the next night.” My husband is a pharmacist, so he took a look at the packaging and said, definitively, “You need to waste it each night.”

“Really? Are you sure? I’m not sure I’ll have enough if I do that…”
“Yes, I’m absolutely positive. If you don’t, it could start growing things. There are no preservatives in here. You need to waste it.”
“Okay, I guess I’ll just refill it if I run out.”

So when my nurse called yesterday to tell me to start the Follistim and the Luveris, I confirmed that i was just taking half a vial of Luveris each night. “Yes, so put in 1cc of sterile water and mix the Luveris and then draw out half and put the rest in the fridge for the next night.”

“Um, really? Because S said I couldn’t do that…”

My nurse said they’ve been told for years you can do that and said that I’m more than welcome to refill it if that would make him happy or I could check with the pharmacy I filled it at, or whatever worked for us, but that they’ve never had a problem with it, etc. Oooookay.

Not really keen on getting a skin infection from a random bottle of Luveris, I thought maybe my husband (who works in a hospital and therefore doesn’t work with a lot of fertility meds)… ANYWAY, I figured maybe I should call the pharmacist that specializes in this stuff. So I did and I explained that my pharmacist husband was a little jumpy about me reusing the vial, but that my nurse had told me to do so and what did THEY recommend?

“Well, I can’t recommend that. You’d run the risk of an infection, and the manufacter doesn’t recommend it either. I’m sure your doctor’s office has never had a problem with it, which is why they say it’s fine, but it’s not something I can recommend.”

So fine. Then my husband comes back with, “Well, you can put it in the fridge and tomorrow you can just look at it and see if the solution is clear or cloudy. If it’s clear, you’re good.”

“Well, is that a definitive test?”
“No.”
“Well, here’s the thing, it’s a $50 copay to refill it once vs. my personal safety here. $50 isn’t cheap. It’s an unlikely reaction I could have. $50 isn’t cheap, but it’s yet another $50 on top of all the other $50 copays we’ve paid for all the other medications. Sooner or later it adds up to real money. But it’s $50 vs. the possibility of an infection…”
“Yeah. Refill the medication.”

I mean, I’m not trying to be Ms. DramaRama here, but seriously. How stupid would I feel if I ended up with the creeping crud because of this?

Anywhozit, stims started last night. Still taking Lupron. Headaches still suck mightily. I haven’t killed my husband yet, though, which is a positive sign. Back to the clinic on Thursday.

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It’s not you, it’s me.

Heh. Actually, the break up with The Hatchery went better than I thought. The nurse happened to call me to see if I was still planning to start my IVF cycle in a week and a half. I didn’t say, “Well, yes, but not with you!” I instead fudged the truth slightly and said that just that week my insurance had taken an odd little twisty turn and now I was on a plan that didn’t cover them, and if I went to them it would be out of network, etc. etc.

She was super nice about it and said that it made a LOT more sense for me to go back to Ye Olde Fertility Clinic and told me to get my records (small as they are) sent back over to them and to let her know how things turned out, etc.

Such a lot of stress for nothing.

Meanwhile, BCPs are making me a blubbering mess, AND I’m all crampy and icky and having spotting/breakthrough bleeding, so I’m not even having the benefit of no period! Hello? The whole POINT of back to back pill packs is to avoid all of the PMSy period stuff! Gah. This is completely unfair.

But … things are moving along. I got all my drugs for the IVF cycle yesterday. My copay for everything was $125. Not too shabby. And I’ve got refills on everything, which rocks. I still don’t know when I’m supposed to start the Lupron. Waiting for that day is agonizing. Hello? When is that going to happen? SIGH.

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I had my mock embryo transfer. I now have a mock embryo on board. I will love him, and hug him, and call him George. I hope he will grow into a perfect little mock fetbryo some day.

But seriously, folks. It turns out, I still have a uterus. Go figure. And ovaries. And hey! My ovaries? They’re stiiiiiiill perky! Who knew? And I once again got called meshuga by SuperDoc. He told the nurse who was there that I wanted to put back 5 embryos, but he talked me down to 4. Yeah. Something like that.

Anyway, if I can get my test results transfered over to Ye Olde Fertility Clinic from The Hatchery right quick, I should be able to get this show on the road really quickly. It’s incredible how quickly YOFC moves.

I didn’t ask SuperDoc about not doing the Lupron protocol – Dr. McB at The Hatchery was planning on using an antagonist protocol instead of a Lupron protocol to avoid OHSS. Dr. McB’s belief is that Lupron is partly responsible for OHSS issues in patients with my profile. I thought about mentioning this theory to SuperDoc, but he is confident that he can keep my risk under control, and I am confident in his experience, and I don’t feel like playing back-seat-doctor in his office right now. I am all set to start Lupron as soon as the doc gives the go ahead, which will be as soon as I have my pap smear, ID blood work, and HSG report all sent over from The Hatchery. Whoo Hoo.

Oh, and I confirmed financials with the insurance company last night. No preauthorization required. SuperDoc is an authorized in-network doctor, so I can just go ahead and do whatever I want. Copay is ridiculous – $40 per visit, $1500 coinsurance for the IVF, etc. But it could be much, much, much worse. I could have no coverage at all. Drug coverage is $50 per prescription, so my nurse is going to call in a LOT of medication, rather than making me get refills as I go along. I love her. 🙂

That is all. Love to all, from the perky one.

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…and all I have to show for it is a picture of a plastic uterus:

Okay, so I have a little more to show for it than THAT.

I met with Ye Olde Fertility Clinic this afternoon. SuperDoc called me back with a bit of a smirk on his face. He looked… bemused. I said, “I’ll bet you never expected to see me again!” “No, no I most certainly did not!” I told him that if he could see the gorgeous smiles on my babies’ faces every morning, he would know why I have to make more babies.

“Well,” he said, “I’ll tell you for sure, if you’re serious, all I have to say is IVF with SINGLE embryo transfers; no discussion.”

“You think??” I retorted. “Hello? I begged for IVF the last time around. I swore to you I’d end up with HOMs if I did IUI and from the looks of my ultrasound report from that day, I’m lucky I didn’t end up with three or four more!”

He pulled up my charts on the screen and said that it was really out of the realm of possibility – my estrogen level was very low, so low, in fact, that the possibility of HOMs hadn’t even been on the radar. This was also why they weren’t concerned about me hyperstimming when I triggered – with estrogen that low, it wasn’t a factor. This made me feel significantly better about what I’d found in the report, at least with regards to the risk of hyperstimming. I still maintain that if I’d ended up with HOMs, given the follicles that I had, low estrogen or not, I’m lucky I didn’t end up with a few more.

Anyway, I told him I’d met with The Hatchery and that they’ve never done elective single embryo transfers – I’m petrified of that. Ye Olde Fertility Clinic does ~15% SETs in their cycles (and has a 67% pregnancy rate in those elective SETs – but that’s because with elective SETs, generally you’re dealing with a population of women who have lots of very high quality embryos to choose from. He predicts that my chances of pregnancy in an elective SET cycle are closer to 40%). I do have a 2% chance of having monozygotic twins in an SET. It does happen. But then we’d just know G-d has a sick and twisted sense of humor and that would be the end of that.

I’m doing my mock embryo transfer/sonohystogram tomorrow at 7:45am. I’ll be starting on Lupron injections either this week or in a couple weeks, depending on what my nurse tells me in the next couple days. Then 125IUs of Follistim injections and 37.5 of Luveris (I have no experience with Luveris whatsoever – do any of you?). We’ll likely be aiming for a 5 day transfer since with SETs they try to go to blast.

I have to send my HSG results from The Hatchery and my ID bloodwork from The Hatchery. My nurse is calling in my drugs to the pharmacy downstairs from their offices ASAP. We’ll get everything rolling as soon as we can. My husband and I have a notary public coming over this week to get our consent forms signed (if they’re not signed in the office, they have to be notarized. Since my husband and I are never in the office at the same time to sign the consents – a notary it is. Sigh. Big pain in the tushie.

And that’s all the interesting news there is. Now I need to go to bed.

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